Glasgow Daily Times, Glasgow, KY

Health

July 22, 2009

Boy overcomes tick-borne illness

High fever one symptom of life-threatening disease

GLASGOW — One local mother hopes she can help keep other parents and their children from going through what she and her son faced recently.

Valerie Lewis found a tick on her son, Parker, 2, on Father’s Day. She removed it and didn’t really think anything else about it.

Three days later, Parker had developed a high fever and was lethargic.

Valerie took her son to her local family physician, Dr. David German, who checked Parker’s tonsils and ears, but couldn’t find an immediate source of infection. He told her to wait a day and see if there were any changes.

Parker’s high fever and lethargy continued the next day and he had a febrile seizure, which consists of convulsions brought on by a fever in infants and small children.

Valerie took Parker to the emergency room at T.J. Samson Community Hos-pital and he was admitted.

Parker was given Doxocycline, an antibiotic, but his white blood cell count kept dropping and Dr. German realized there was “something different about this one.”

Parker was diagnosed with Ehrlichiosis, an illness carried by the Lone Star tick that is found in the southeastern United States.

He was treated at the local hospital for two days, but was not showing improvement.

The boy’s white cell count continued to decrease from 3,500 to 2,000 to 800, according to German, so the decision was made to send Parker to Vanderbilt Hospital, the Monroe Carell Jr. Children’s Hospital, in Nashville.

After Parker arrived at Vandy, he began to bounce back and was released after two more days of treatment there.

“It took four days to get as bad as he was going to get,” Valerie said. “After that he started bouncing back.”

Parker has now completely recovered with no lasting ill effects or organ damage.

“The doctors at Vanderbilt told me that Ehrlichiosis is especially bad this year in Tennessee and Kentucky, up 100-fold from last year,” Valerie said. “ The disease is potentially deadly (two children died from it while Parker was at Vanderbilt). It's important that parents think about tick bites if their child has an unexplained high fever in the summer with low white blood cell counts.

Valerie said doctors in Tennessee attributed German with quick thinking that helped Parker’s case be resolved with a positive outcome.

“He is the reason. They said Dr. German did everything exactly right,” Valerie said.

“I was just doing my job,” German said.

The thing to take away from all this, he said, is in the summertime, if a child 8 or younger has an unexplained fever of 104 degrees or higher that is not going away and a white cell count that keeps dropping, parents and physicians need to think about tick bites as a possible cause of the illness.

Other than that, German was humble about his discovery of the right diagnosis in Parker’s case.

“Praise the Lord he got better,” he said. “God puts those ideas in your mind at the right time.”

What is Ehrlichiosis?

Ehrlichiosis is the general name used to describe several bacterial diseases that affect animals and humans. These diseases are caused by the organisms in the genus Ehrlichia. In the United States, there are currently two ehrlichial species that are known to cause disease in humans: Ehrlichia chaffeensis and Ehrlichia ewingii. Ehrlichia chaffeensis causes human ehrlichiosis also described as human monocytic ehrlichiosis (HME). In addition, human infections with Ehrlichia ewingii have also been documented.

How do people get ehrlichiosis?

In the United States, ehrlichiae are transmitted by the bite of an infected tick. The lone star tick (Amblyomma americanum) is the primary vector of both Ehrlichia chaffeensis and Ehrlichia ewingii in the United States.

What are the symptoms of ehrlichiosis?

The symptoms of ehrlichiosis may resemble symptoms of various other infectious and non-infectious diseases. The initial signs and symptoms generally include:

* fever

* headache

* fatigue

* muscle aches

Other signs and symptoms may include:

* nausea

* vomiting

* diarrhea

* cough

* joint pains

* confusion

* occasionally rash

Symptoms typically appear after an incubation period of 5-10 days following the tick bite. It is possible that many individuals who become infected with ehrlichiae do not become ill or they develop only very mild symptoms.

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